Provider Demographics
NPI:1225563778
Name:BAY AREA CHILDREN'S ASSOCIATION
Entity Type:Organization
Organization Name:BAY AREA CHILDREN'S ASSOCIATION
Other - Org Name:BAY AREA CHILDREN'S ASSOCIATION MENLO PARK
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-996-7950
Mailing Address - Street 1:1175 SARATOGA AVE
Mailing Address - Street 2:STE 14
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3440
Mailing Address - Country:US
Mailing Address - Phone:408-996-7950
Mailing Address - Fax:408-996-7997
Practice Address - Street 1:1162 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4308
Practice Address - Country:US
Practice Address - Phone:650-304-3906
Practice Address - Fax:650-304-3907
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY AREA CHILDREN'S ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty